Individual provider Active NPI

Shanna Neff, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1528346194
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP-1094A Issued in ID
Practice address
2375 E Sunnyside Rd Ste C
Idaho Falls, ID 83404-8281
Phone
(208) 529-5777
NPI assigned
Jul 29, 2011
Last updated
Aug 16, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP-1094A ID Primary

Addresses

Primary practice location

2375 E Sunnyside Rd Ste C
Idaho Falls, ID 83404-8281

Mailing address

2375 E Sunnyside Rd Ste C
Idaho Falls, ID 83404-8281
Phone (208) 529-5777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
NP-1094AIDMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1528346194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 E SUNNYSIDE RD STE C",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048281",
            "telephone_number": "208-529-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 E SUNNYSIDE RD STE C",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048281",
            "telephone_number": "208-529-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEFF",
        "first_name": "SHANNA",
        "credential": "MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-29",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "NP-1094A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.